Atrial Fibrillation Ablation Outcomes by Hospital Academic Status

Department

Cardiology

Document Type

Article

Publication Title

Catheterization and Cardiovascular Interventions

Abstract

Background: Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide, and catheter ablation has been established as an effective treatment modality. The outcomes can vary based on medical expertise and the location of the procedure. This study evaluates the differences in outcomes of catheter ablation performed at non-academic compared to academic institutions.

Aims: To compare the outcomes of atrial fibrillation procedures executed in non-academic versus academic centers.

Methods: A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Adults (35-90 years) who underwent AF ablation between January 1, 2010, and January 1, 2020, were included. Those with congenital malformations of circulatory system, rheumatic heart disease, ischemic cardiomyopathy, or prior myocardial infarction (MI) were excluded. Groups were stratified by hospital academic status and balanced using 1:1 propensity score matching. Outcomes were assessed within 365 days post-ablation. Patients with outcome prior to the time window were excluded, and the odds ratio was used for statistical comparisons with significance set at p < 0.05.

Results: Following propensity score matching, the analysis revealed that patients undergoing AF ablation at non-academic institutions had significantly higher odds of requiring additional or redo ablation (OR: 1.844; 95% CI: 1.409-2.415) and developing acute kidney injury (OR: 1.534; 95% CI: 1.054-2.232) compared to those treated at academic institutions. Other post-ablation complications, including cardiac arrest (OR: 1.101; 95% CI: 0.466-2.599), cardiac tamponade (OR: 1.101; 95% CI: 0.466-2.599), esophageal perforation (OR: 1.000; 95% CI: 0.415-2.409), and hemorrhages or hematomas (OR: 0.909; 95% CI: 0.385-2.145), did not differ significantly between the two groups.

Conclusion: Catheter ablation of AF performed at academic hospitals resulted in better outcomes, potentially reflecting advanced technical expertise, post-op care, and better institutional resources. These results highlight the importance of standardization of care and the need for increased access of high-standard care across healthcare settings. Future studies should investigate modifiable institutional factors and patient-level variables driving this disparity.

First Page

2004

Last Page

2012

DOI

10.1002/ccd.70570

Volume

107

Issue

6

Publication Date

5-1-2026

Publisher

Wiley-Liss

Medical Subject Headings

Humans; Atrial Fibrillation; Retrospective Studies; Middle Aged; Male; Catheter Ablation; Female; Aged; Treatment Outcome; Adult; Risk Factors; Time Factors; Aged, 80 and over; Risk Assessment; Academic Medical Centers; Healthcare Disparities; Postoperative Complications; United States

PubMed ID

41866697

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